Dizziness

What is dizziness?

Dizziness is the sensation of feeling lightheaded or off-balance. It is closely associated with the sensory organs, particularly the eyes and ears, and can occasionally lead to fainting. Dizziness should not be mistaken for a disease; instead, it is a symptom of various underlying disorders.

What are the causes of dizziness?

Dizziness encompasses a range of potential causes, with true dizziness being the sensation of lightheadedness or feeling nearly faint. However, dizziness, vertigo, and disequilibrium are distinct experiences with their characteristics:

• Vertigo involves a spinning sensation akin to feeling like the room is moving or experiencing motion sickness. It may also give the impression of leaning to one side.
• Disequilibrium: This refers to a loss of balance or equilibrium.

One common cause of vertigo and related dizziness is benign positional vertigo (BPV), which leads to brief episodes of dizziness when a person changes positions rapidly, such as sitting up abruptly after lying down. Meniere’s disease is another potential cause. It is characterised by fluid buildup in the ear, along with symptoms like ear fullness, hearing loss, and tinnitus, which contribute to dizziness and vertigo.

Acoustic neuroma, a noncancerous tumour that develops on the vestibulocochlear nerve (auditory nerve) connecting the inner ear to the brain, can also cause symptoms of dizziness and vertigo.

Common causes

Dizziness can arise from various causes, including dehydration, which occurs when the body loses too much fluid. Symptoms of dehydration include thirst and dry skin. Other common triggers of dizziness include migraine attacks and alcohol consumption. Issues within the inner ear, responsible for sensing movement and maintaining balance, can also lead to dizziness, often accompanied by hearing loss. Certain medications may contribute to dizziness as a side effect. These medications include muscle relaxants, antiepileptic drugs, antihistamines, and blood pressure medications.

When to report to a health facility about dizziness?

It’s crucial to seek medical attention promptly if you experience repeated bouts of dizziness or sudden dizziness accompanied by any of the following symptoms:

• A head injury
• A headache
• Neck stiffness
• A high fever
• Ongoing vomiting
• Blurred vision
• Hearing loss
• Tinnitus
• Difficulty speaking
• Numbness or tingling
• Droopiness of the eye or mouth
• Loss of consciousness
• Chest pain
• Heart palpitations or a low heart rate

These symptoms may indicate a severe health issue, so it’s essential to visit a clinic or notify a doctor immediately for evaluation and appropriate management.

What is the treatment for dizziness?

A wide array of treatment options are available for dizziness, each tailored to the underlying cause. This diversity of treatments offers hope and optimism, as there’s likely a solution that will work best for you. Here are potential treatments for various causes of dizziness:

Benign Positional Vertigo (BPV):

• Epley Maneuver: A series of head movements to reposition displaced inner ear crystals.
  • Canalith Repositioning Procedures: Alternative manoeuvres to help alleviate vertigo symptoms.

Meniere’s Disease:

• Medications: Diuretics to reduce fluid buildup, anti-nausea medications, and vestibular suppressants.
  • Low-Salt Diet: Helps reduce fluid retention in the inner ear.
  • Injections: Corticosteroids or antibiotics directly into the inner ear.
• Surgery: Reserved for severe cases unresponsive to other treatments, such as endolymphatic sac decompression or vestibular nerve section.

Acoustic Neuroma:

• Monitoring: Regular observation to monitor tumour growth.
  • Radiation Therapy: For slow-growing tumors to reduce their size.
  • Surgery: Surgical removal of the tumour if it affects hearing or balance.

Dehydration:

• Fluid Replacement: Drinking water or oral rehydration solutions to restore lost fluids and electrolytes.

Migraine-Related Dizziness:

• Medications: Triptans or other migraine-specific medications to alleviate symptoms during an attack.
  • Preventive Medications: To reduce the frequency and severity of migraines.
  • Lifestyle Changes: Identifying triggers (e.g., certain foods, stress) and making appropriate lifestyle adjustments.

Inner Ear Disorders (e.g., Vestibular Neuritis, Labyrinthitis):

• Medications: Antivertigo medications (e.g., meclizine) to alleviate symptoms.
  • Physical Therapy: Vestibular rehabilitation exercises to improve balance and reduce dizziness.

Medication-Induced Dizziness:

• Adjustment of Medications: Changing dosage or switching medications under medical supervision.

Orthostatic Hypotension (Sudden Drop in Blood Pressure):

• Lifestyle Modifications: Increasing salt intake, wearing compression stockings, and avoiding sudden changes in posture.
  • Medications: Adjusting blood pressure medications to prevent drops in blood pressure.

Cardiac Causes (e.g., Arrhythmias, Cardiomyopathy):

• Medications: To control heart rhythm (e.g., beta-blockers, anti-arrhythmic drugs).
  • Surgical Interventions: Procedures such as pacemaker implantation or cardiac ablation may be necessary.

Anxiety-Related Dizziness:

• Therapy: Cognitive-behavioral therapy (CBT) or counselling to address anxiety symptoms.
  • Medications: Antidepressants or anti-anxiety medications prescribed by a healthcare provider.

Anemia:

• Iron Supplementation: To address iron deficiency anaemia and improve symptoms.

Hypoglycemia:

• Glucose Administration: Consuming glucose tablets, fruit juice, or other sugary substances to raise blood sugar levels.

Carbon Monoxide Poisoning:

• Oxygen Therapy: Administered via a mask or ventilator to increase oxygen levels in the blood.
  • Hyperbaric Oxygen Therapy: In severe cases, to rapidly eliminate carbon monoxide from the body.

Stroke:

• Emergency Treatment: Immediate medical attention for clot-dissolving medications (thrombolytics) or clot retrieval procedures (mechanical thrombectomy).

Malignant Tumors and Brain Disorders:

• Treatment Plan: Individualized based on the type and location of the tumour or brain disorder, including surgery, radiation therapy, chemotherapy, or supportive care.

Each treatment approach must be customised based on the specific diagnosis and the patient’s requirements. Seeking medical evaluation and guidance is crucial to identify the underlying cause of dizziness and promptly start appropriate treatment.

What are the tips for managing dizziness?

These are some tips for managing recurrent bouts of dizziness:

• Sit or Lie Down Immediately: When you feel dizzy, sit or lie down immediately to prevent falls and injuries. Rest until the dizziness subsides.
• Use Assistive Devices: Use a cane or walker for stability and reduce the risk of falling.
• Use Handrails: Always use handrails for added support and safety when navigating stairs or uneven surfaces.
• Balance-Improving Activities: Consider engaging in activities like yoga or tai chi, which can help improve balance and coordination over time.
• Avoid Sudden Movements: Minimize sudden movements or changes in position, which can trigger or exacerbate dizziness.
• Avoid Driving and Operating Machinery: If you experience frequent dizziness without warning, refrain from driving or operating heavy machinery to prevent accidents.
• Avoid Triggers: Stay away from caffeine, alcohol, and tobacco, as these substances can potentially trigger dizziness or worsen existing symptoms.
• Stay Hydrated and Get Enough Sleep: Drink plenty of water and ensure adequate sleep to maintain overall health and reduce the likelihood of dehydration-induced dizziness.
• Manage Stress: Avoid stressful situations when possible, as stress can contribute to dizziness.
• Medication Review: If you suspect a medication is causing your dizziness, discuss with your doctor about adjusting the dosage or switching to an alternative medication.
• Cool Environment: If dizziness is due to overheating or dehydration, rest in a cool place and drink water to rehydrate.

Always prioritise your safety and well-being. If you’re concerned about the frequency or severity of your dizziness episodes, consult a healthcare professional for proper evaluation and management. They can help determine the underlying cause and recommend appropriate treatment strategies tailored to your needs.